Last Updated:

January 30th, 2026

Bipolar disorder and addiction

What is bipolar disorder?

Bipolar disorder is a mood condition that causes a person to experience emotional states that sit far apart from each other. These states, called manic and depressive episodes, create changes in energy and behaviour that can reach into daily life more deeply than regular mood fluctuations.

In the UK, bipolar disorder affects a significant number of adults and can develop in late adolescence or adulthood. The early signs may appear subtle, especially if the person is experiencing shorter or less intense mood changes, yet as the pattern strengthens it becomes clearer that the highs and lows follow a distinct cycle.

Bipolar disorder exists on a spectrum that includes bipolar I, bipolar II and cyclothymia. The severity and duration of episodes can vary widely and the way the condition presents itself differs from one person to another.

bipolar and addiction balloons representing moods

What are the signs of bipolar disorder?

The signs of bipolar disorder develop through the contrast between manic and depressive states. These contrasts gradually create a pattern that becomes difficult to overlook. Someone experiencing mania may notice that their sleep decreases without feeling tired, their thoughts race and their confidence rises sharply. This can lead to decisions that feel exhilarating in the moment but carry consequences that become clearer later.

Depressive episodes move in the opposite direction and can create emotional heaviness, reduced motivation, disrupted sleep and a sense of disconnection. Concentration can weaken and the person may feel unable to engage with tasks that once felt manageable.

Some people with bipolar disorder also experience periods of relative stability between episodes, yet the uncertainty around when the next mood change may emerge can create its own strain. If several of these signs have been present and are affecting daily life, speaking with a professional can clarify whether bipolar disorder may be contributing to these experiences.

How can bipolar disorder impact a person’s life?

Without appropriate support, bipolar disorder can influence nearly every area of life because the emotional extremes affect thinking and behaviour in ways that build gradually.

Work and education can become challenging during manic or depressive episodes. During mania, a person may take on tasks quickly yet struggle to finish them, while during depressive states, concentration and motivation can drop sharply. This creates a cycle of inconsistency that affects performance and confidence. Research consistently shows that people with bipolar disorder experience higher levels of employment instability, with a noticeable gap in long-term job retention compared with those without the condition.

Relationships can also be strained. Mood changes can influence communication, emotional availability and the level of connection the person can maintain. Someone in a manic state may speak rapidly or make decisions others find confusing, while depressive periods can lead to withdrawal or silence that loved ones may interpret as disinterest. These misunderstandings can create distance that neither side intended, leaving the person feeling misunderstood and unsure how to repair the tension.

Physical wellbeing is influenced too. Sleep disturbances are widespread in both manic and depressive episodes and appetite can rise or fall depending on the emotional state. Extended cycles of poor sleep or disrupted energy levels can place the body under pressure, which increases vulnerability to further health issues. These physical effects combine with emotional strain, creating a complex picture that requires understanding rather than judgement.

One of the most concerning aspects of bipolar disorder is its connection with addiction, which is explored in the next section.

The link between bipolar and addiction

Living with bipolar disorder does not mean a person will experience an addiction, yet the intense highs and lows can create vulnerabilities that make certain substances or compulsive behaviours feel appealing in moments of distress or instability. Some turn to these behaviours during depressive episodes to soften emotional heaviness, while others use them during manic states when judgment, impulse control and risk awareness weaken.

The connection between the two becomes clearer when each type of addiction is examined separately, since the emotional needs that sit behind manic and depressive symptoms can interact differently with different addictive patterns. Looking at these links individually helps reveal how the person’s internal experiences and their coping strategies become tied together.

  • Bipolar disorder and alcohol addiction – A study found that in bipolar I/II patients, more problematic alcohol use predicted worse mood and lower work functioning over subsequent months.
  • Bipolar disorder and cannabis addiction – A 2023 prospective study of bipolar I/II patients found that 36.1% had a comorbid cannabis use disorder and those with CUD showed markedly worse outcomes.
  • Bipolar disorder and stimulant drug addiction – Studies suggest that using large amounts of amphetamines or cocaine can produce symptoms that look very similar to mania. It also found that for people who already have bipolar disorder, heavy use of these stimulants may increase the chance of triggering an actual manic episode, rather than just mimicking one.

How are those with bipolar disorder and addiction treated?

When bipolar disorder and addiction appear together, the most effective support acknowledges both conditions at the same time. Treating one while overlooking the other leaves significant challenges in place, especially when the addiction has developed through attempts to manage manic or depressive symptoms.
Therapies used in addiction support can be adapted carefully for someone with bipolar disorder. CBT can help explore thoughts that intensify during emotional highs or lows, while DBT can support emotional regulation during periods when mood feels unpredictable. Therapies that calm the nervous system, such as mindfulness-based approaches or movement-based activities, can help the person reconnect with stability without relying on harmful coping behaviours.

Medication for bipolar disorder is still part of treatment when addiction is present, yet the approach needs to be considered carefully.

Does addiction rehab differ for those with bipolar disorder?

The structure of rehab stays broadly similar but the environment adapts to create predictability and reassurance. Detox can feel unsettling because changes in mood and withdrawal symptoms combine, so clear communication and a steady routine help reduce confusion during this phase.

Therapy sessions are shaped around understanding how the person’s bipolar symptoms contributed to addictive behaviours. This might include looking at impulsive decisions made during mania or the emotional emptiness during depressive episodes that pushed the person toward substances or compulsive behaviours.

As these connections become clearer, the person gains a deeper understanding of themselves and the challenges they face.

The next steps

If you’re living with bipolar disorder and feel concerned about your relationship with substances or certain behaviours, you don’t need to work through this alone. Speaking with an addiction specialist can clarify what support suits you and how both conditions can be addressed in a way that feels manageable. Reaching out can give you a clearer route forward and the reassurance that change is possible.

Frequently Asked Questions

Do people with bipolar have addictions?
People with bipolar disorder experience higher rates of addiction because mood shifts can influence impulse control and coping habits. Substance use may start as relief but gradually becomes a separate struggle.
What mental illness is most associated with addiction?
Depression, bipolar disorder, schizophrenia and anxiety conditions show strong links with addiction, but no single condition stands above all others. The connection depends on individual vulnerability, coping style and life circumstances.
What should people with bipolar disorder avoid?
People with bipolar disorder are encouraged to avoid inconsistent sleep, heavy alcohol use and stimulant substances because these can destabilise mood and make symptom management noticeably harder.

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